Volume 18, Number 4

Peter DO Davies DM FRCP Director, Tuberculosis Research Unit, Cardiothoracic Centre, Liverpool

BCG is an attenuated form of Mycobacterium bovis, which was developed by two French men – Calmette and Guerin – by passage of the bacillus over 100 times. It was ready for trials in the 1920s. Unfortunately, in 1927 there was a mix-up of vaccine with live M tuberculosis in Lubeck and infants were injected with the live tubercle bacillus instead of BCG. Many of them died and it took many years for BCG to get over its erroneously earned bad reputation.1

John A Hughes MB ChB FRCP Consultant Physician, Chest Unit, Kent and Sussex Hospital, Tunbridge Wells

The British Thoracic Society (BTS) published its Guidelines for the management of chronic obstructive pulmonary disease in 1997.1 These guidelines summarised the views of many individuals and organisations, and were based on a combination of clinical judgement and a review of the literature on the subject.

Terence Seemungal MSc MBBS MRCP Specialist Registrar in Chest and General Medicine and Honorary Research Fellow; Jadwiga A Wedzicha MA MD FRCP Professor Academic Respiratory Medicine, St Bartholomew’s and Royal London School of Medicine and Dentistry, St Bartholomew’s Hospital, London

This review considers the incidence of respiratory virus infections in asthma and COPD, their effects on symptomatology, airway inflammation, morphology and physiology. Co-factors of virus infection and possible mechanisms of infection are also discussed. Recently emerged evidence for chronic viral infection in COPD will be explored.

Nicola Peel DM FRCP Consultant in Metabolic Bone Medicine, Honorary Senior Lecturer, Northern General Hospital, Sheffield

Current guidelines for the management of asthma advocate early intervention with inhaled corticosteroids.1 These agents are also widely used in the management of chronic obstructive pulmonary disease (COPD). Three compounds are licensed in the UK; beclometasone dipropionate (BDP), budesonide (BUD) and fluticasone propionate (FP).

Michael Morgan MD FRCP Consultant Physician in Respiratory Medicine, Glenfield Hospital, Leicester

In the UK the management of incurable chronic disease is generally neglected in favour of the emphasis on acute emergency care or surgical procedures. This may be an expedient policy in a financially restrained health service, but in other countries where the true burden of chronic disease is recognised, such neglect is evidently not tolerated.

Philip Ind, Editor

Respiratory medicine is currently in the news. The recent British Thoracic Society press release highlights The Burden of Lung Disease. This report, compiled by the Department of Public Health at Oxford University, summarises the total burden of lung disease in the UK in terms of deaths, disability and economic costs.1

Anita K Simonds MD FRCP, Royal Brompton and Harefield NHS Trust London

There has been an almost exponential growth in the use of non-invasive ventilation (NIV) in the last decade. This is largely due to the recognition that non-invasive nasal mask ventilation can reduce mortality and morbidity in a range of acute and chronic pulmonary disorders in adults. In parallel to these widening indications, improvements in ventilator and mask design have taken place.